Welcome to occupational therapy

The aim of our paediatric occupational therapy service is to enable children to participate in daily activities to improve health, independence and well-being.

The Occupational Therapy team provide assessment and intervention for babies, children and teenagers who have challenges with everyday activities (or occupations) as a result of illness, injury or a pre-existing condition. This may include:

Self-care e.g. self-feeding, getting dressed, bathing and toileting
Play and social interaction
Productivity e.g. school skills such as writing, typing, using scissors and drawing
Learning and development
Accessing the home, community or education environment

We support safe discharge from hospital, which may include the provision of equipment, modifying activities and/or modification of the ward and home environment.

For further information please see the College of Occupational therapist leaflet.

Meet the team

Lisa Mills - Lead occupational therapist and highly specialist occupational therapist in osteogenesis imperfecta

Rebecca Muir - Specialist paediatric occupational therapist in Neurology

Rebecca Johns - Specialist paediatric occupational therapist in Burns

Poppy Greenman - Specialist paediatric occupational therapist in Rheumatoid Arthritis and Long Covid

Julia Smyth - Specialist paediatric occupational therapist in Barth Syndrome

Elise Thompson - Specialist paediatric occupational therapist in Neurology

Libby Iandi-Rosser - Senior Rotational Occupational Therapist

Jennifer Sellers - Senior occupational therapist in General Inpatients

Meadhbh Dunne - Junior occupational therapist in Orthopaedics

Elizabeth Martin - Occupational therapy assistant

Contact details

Service hours are Monday to Friday 8am-4.30pm

Tel: 0117 342 8429

The OT in Trauma and Orthopaedics works as part of the multidisciplinary team. For elective (planned) orthopaedic surgeries the OT will complete a pre-operative assessment over the phone with parents and carers. This is to help families prepare for surgery and the practicalities of day to day life after the operation. The OT will also see children and families on the ward after surgery (planned and unplanned) to work towards a safe discharge from hospital.

The role of the Occupational Therapist includes:

Working with children who have a change in level of functionality
Identifying the need for specialist equipment or home adaptions prior to discharge
Providing a limited selection of temporary equipment
Liaising with community services
Liaising with schools and nurseries to support children in having a safe and timely return post-operation

Wheelchairs

Some children may need a wheelchair temporarily after an operation; we have a limited number of wheelchairs and buggies we can loan out to children who have had certain types of surgery. We also often advise parents/carers to go to the Red Cross who loan out wheelchairs on a short term basis.

http://www.redcross.org.uk/Where-we-work/In-the-UK/Southern-England/Wiltshire-Avon-and-Gloucestershire/LocalServices/Mobility-aids/?dpid=d76b3383-024b-4e52-b507-a732b318b9db

Hip Spica Casts

Many children we work with will be going into a hip spica cast. Below is some useful information and links which can help parents prepare for caring for their child in a spica.

Car seat

Maxi Cosi have adapted their Opal car seat for children in hip spica casts as often they will be unable to fit into their current car seats. These can be hired; follow the link below for information on their scheme:

http://www.steps-charity.org.uk/conditions/hip-dysplasia-ddh/hip-spica-car-seat/

Caring for your child at home:

The OT will go through with parents the practicalities of being in spica and help families to plan for any adjustments they will need to make. Below are some useful resources for parents.

http://www.steps-charity.org.uk/

http://www.steps-charity.org.uk/wp-content/uploads/2016/06/Hip-Surgery-and-Spica-Cast-Care-1.pdf

http://www.nhs.uk/conditions/developmental-dysplasia-of-the-hip/Pages/Introduction.aspx

The Highly Specialised Osteogenesis Imperfecta service is one of four specialist centres commissioned by NHS England. It was set up to offer a multi-disciplinary service to children and young people with Osteogenesis Imperfecta. The Bristol Team covers the south-west of England and also provides support to children in South Wales on a case by case basis. Occupational Therapy for the Osteogenesis Imperfecta service is provided on an in-patient, out-patient input and community basis.

The role of the Occupational Therapist working with a child with Osteogenesis Imperfecta includes:

Advice on appropriate handling, positioning and managing daily cares (dressing, changing nappies etc) for parents of infants / toddlers to prevent fractures and promote development.
Provide detailed assessments and treatments to promote and maintain functional independence.
Assessment and recommendation of equipment for school and home environments including wheelchairs
Liaison with orthopaedic surgeon regarding planned surgeries, and managing fractures to ensure safe discharge from hospital
Provide targeted rehabilitation following fractures.
Provide education packages to nurseries, schools and child care providers to maximise inclusion
Liaison with professional peer groups nationally to develop national guidelines, audit and research.
Provide support /education to other healthcare professionals.

Useful Links http://www.brittlebone.org/

The Occupational Therapist provides an inpatient service for children who have experienced a brain injury or spinal injury.

The multidisciplinary neurorehabilitation team is consultant led and consists of physiotherapy, speech and language therapy, Occupational therapy, Psychology, dietetics, play therapy, music therapy and nursing team, as well as a discharge planning coordinator.

This may include children who have had the following:

Open or closed traumatic brain injury
Non- traumatic brain injury such as

Tumours

Infection

Anoxia

Stroke

AVMs or

Those experiencing new symptoms or complications arising from a pre-existing neurological or developmental condition.

The role of the Occupational therapist working with a child with an acquired brain injury includes:

Assessment of low awareness and minimally consciousness
Assessment of the impact of injury on child's physical and cognitive abilities within their normal developmental milestones
Assessment of child's social and environmental circumstances, which may include the need of some local home visits
Provision of a rehabilitation programme to include:

-Provision of appropriate sensory input and regulation to maximise awareness in low and minimally responsiveness and provide advice to both staff and patients

-Maximising potential , enhance participation and independence through practice and where necessary provision of adaptive strategies in all performance areas such personal care, daily living activities, play, leisure and school

-Targeted ongoing therapy to improve function in upper limbs, participation in play/school/self-care tasks and cognitive functioning

-Promote 24 hour postural and tone management to include provision / referral for sleep, and or seating equipment and upper limb splints

Provide advice and or arrange equipment provision, including specialist buggies/wheelchairs to maximise safety during home leave as (part of overall rehabilitation) and discharge

Website link:

https://childbraininjurytrust.org.uk/

https://www.stroke.org.uk/finding-support/information-about-stroke-childhood

http://www.clicsargent.org.uk/

The service provides expertise for children and adolescents who suffer from a wide variety of childhood rheumatology conditions and inflammatory diseases as well as musculoskeletal problems, which may include:

juvenile arthritis
uveitis
juvenile onset lupus
juvenile dermatomyositis
rare forms of paediatric vasculitis
mechanical joint pain
functional difficulties associated with hypermobility

The occupational therapist in paediatric rheumatology is part of a multidisciplinary team consisting of consultant doctors and registrars, specialist nurses, a clinical psychologist and physiotherapists. The occupational therapy service primarily consists of outpatient clinics but we may also work with young people on the wards if their care is led by a paediatric rheumatology consultant. The service covers the south west of England and south Wales, so sometimes our patients are coming from far way to clinics and to have their medication administered on CIU.

Treatment focuses on enabling the young person to participate fully in everyday activities which are meaningful to them, including self-care, accessing school, and leisure activities. This often involves developing new skills, problem solving with young people and their parents, making changes to the environment or the task, and recommendations for equipment.

We set functional goals with young people and their families, and treatment may include:

advice regarding everyday activities which will promote hand function and strength
increasing range of movement in the hand and upper limb and grip strength through exercise; this may be to recondition after a period of active JIA affecting fingers and wrists
advice and equipment recommendations to support hand writing, for instance using pen grips or writing slopes
liaison with schools to help teachers understand the condition and how it affects a young person
help to cope with pain and low energy levels by teaching pacing strategies and activity grading
Advice on relaxation and sleep

Useful links:

www.arthritisresearchuk.org

www.jia.org.uk

www.bspar.org.uk

The inpatient service is responsible for the provision of Occupational Therapy assessment and interventions for children and young people who are in-patients at Bristol Children's Hospital. This covers the following areas:

- Medical Wards

- Cardiac Ward

- Paediatric intensive care unit (PICU)

- Oncology

- High dependency unit (HDU)

The acceptance criteria for referrals are:

Children who have a change in level of functional ability
Evolving abnormal presentation of a child or developmental delay due to illness and/or prolonged hospitalisation
Children who require provision of specialist equipment or home assessment prior to discharge.
Children requiring assessment and/or splinting of the upper limb

The role of the Occupational Therapist includes:

Advice on appropriate handling, positioning and managing daily cares for parents and/or other healthcare professionals of children who have experienced a change in functional ability/to promote their development and independence.
To provide advice and programmes on promoting a child's development and independence through positioning and play.
Inpatient rehabilitation to work on specific skills and tasks in order to promote age appropriate skills and independence
Assessment and recommendation of equipment for home and school environments including wheelchairs (this frequently involves working with community therapists).
Attending meetings to discuss patient's care, interventions and ensure a safe and timely discharge
Working with other healthcare professionals (e.g. Physiotherapists, SLT) and other professionals (e.g. play team, school staff) to provide therapy, recommendations and advice.

The Highly Specialised Barth Service is the only centre commissioned by NHS England to offer a multi-disciplinary service to children and young people with Barth Syndrome. The team provides a UK wide service with some European patients. Occupational Therapy for the Barth service is provided on an in-patient, out-patient input and community basis.

The role of the Occupational Therapist working with a child with Barth syndrome includes:

Providing education to newly diagnosed patients and their carers.
Providing detailed assessments and treatments to promote and maintain functional independence.
Assessment and recommendation of environment, equipment and learning strategies for school environments
Providing education packages to nurseries, schools and child care providers to maximise inclusion.
Providing support /education to other healthcare professionals.

Useful Links

http://www.barthsyndrome.org.uk/

Occupational therapy